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Argo Corp. v. Greater New York Mutual

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This opinion is uncorrected and subject to revision before

publication in the New York Reports.

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The Argo Corporation, et al.,

Appellants,

v.

Greater New York Mutual Insurance

Company,

Respondent.

 

G.B. SMITH, J.:

 

The issue in this case is whether a primary insurer can disclaim coverage based

solely upon a late notice of lawsuit or must show prejudice. We hold that,

under the circumstances of this case, plaintiffs’ late notice was unreasonable

as a matter of law, that the Appellate Division correctly applied Matter of

Brandon v Nationwide Mut. Ins. Co. (97 NY2d 491 [2002]) and that the insurer

need not show prejudice.

On January 2, 1997, Igo Maidenek slipped and fell on ice on the sidewalk

adjacent to 137-01, 83rd Avenue in Kew Gardens, New York. Maidenek was a tenant

of the premises. The property was owned by Henry Moskowitz and managed by two

companies owned by Moskowitz, Argo Corporation and Martinique Realty Associates

(Argo).

On February 23, 2000, Maidenek brought suit for personal injuries against Argo

by serving a summons and complaint on the New York Secretary of State. Argo

acknowledged receipt of the summons and complaint by signing a return-receipt

dated February 28, 2000. On November 10, 2000, Argo was served with a default

judgment. On February 13, 2001, Argo received a notice of entry of the default

judgment and of the scheduling of a hearing on that judgment. On February 21,

2001, Argo received service of a note of issue for trial readiness.

Argo notified Greater New York Mutual Insurance Company (GNY), its commercial

liability insurance carrier,[1] on May 2, 2001. On June 4, 2001, GNY disclaimed

coverage because of the late notice of the lawsuit, and occurrence, which,

according to GNY, was a “condition precedent” to coverage under the insurance

policy.[2]

In January, 2003, Argo brought a declaratory judgment action against GNY

challenging GNY’s disclaimer. GNY responded with a motion to dismiss for

failure to comply with the contract provision which required timely notice to

the carrier of the occurrence and of the lawsuit against the insured. The

contract required notice “as soon as practicable.”[3]

Supreme Court agreed that defendant failed to comply with a condition precedent

to coverage under the contract, stating, “Plaintiff’s policy required them to

Asee to it that we [the insurer] are notified as soon as practicable of an

‘occurrence’ or an offense which may result in a claim. Plaintiffs did not

notify defendant of Maidenek’s suit until 14 months after service of the

complaint upon the Secretary of State as their agent, until 6 months after

service of the default motion upon plaintiffs, until more than 3 months after

default was entered and until almost 3 months after service of the Note of Issue

upon plaintiffs.” As a result, Supreme Court granted defendant’s motion to

dismiss for failure to timely notify the insurer.

The Appellate Division affirmed, stating:

“[T]he insureds are unable to provide an excuse for their failure to comply with

the policy’s notice provisions. Unlike in Matter of Brandon v Nationwide Mut.

Ins. Co., (97 NY2d 491), this is not a case where the carrier had prior notice

of the claim before the action was commenced (citations omitted).”

We granted leave to appeal and now affirm.

For years the rule in New York has been that where a contract of primary

insurance requires notice “as soon as practicable” after an occurrence, the

absence of timely notice of an occurrence is a failure to comply with a

condition precedent which, as a matter of law, vitiates the contract (see

Security Mut. Ins. Co. of NY v Acker-Fitzsimons Corp., 31 NY2d 436, 440-43

[1972]) [failure to notify in a timely manner allowed insurer to disclaim

coverage]). No showing of prejudice is required (id.). Strict compliance with

the contract protects the carrier against fraud or collusion (id.); gives the

carrier an opportunity to investigate claims while evidence is fresh; allows the

carrier to make an early estimate of potential exposure and establish adequate

reserves and gives the carrier an opportunity to exercise early control of

claims, which aids settlement (Unigard Sec. Ins. Co. v North River Ins. Co., 79

NY2d 576, 582 [1992]).

We have applied the no-prejudice rule in various contexts in recent years:

supplementary underinsured motorist insurance (SUM)(Matter of Metropolitan Prop.

& Cas. Ins. Co. v. Mancuso, 93 NY2d 487, 495-96 [1999]; cf. Matter of Brandon

and Rekemeyer v State Farm Mutual Automobile Ins. Co. _____NY_____ [decided

today]); and excess insurance (American Home Assur. Co. v International Ins.

Co., 90 NY2d 433, 442-47 [1997]). We have held, however, that the rule

enunciated in Security Mutual does not apply to reinsurance and a reinsurer must

show prejudice before it can be relieved of its obligations to perform under a

contract (Unigard Sec. Ins. Co. v North River Ins. Co., 79 NY2d 576, 582-84

[1992]).

In Matter of Brandon (Nationwide Mut. Ins. Co.)(97 NY2d 491 [2002]), we again

departed from the general “no prejudice” rule and held that the carrier must

show prejudice before disclaiming based on late notice of a lawsuit in the SUM

context (see 97 NY2d 491, 498, supra). Under the facts of Brandon, the carrier

received timely notice of claim but late notice of a lawsuit (see id. at

494-95). We were unwilling to extend the no prejudice exception in regard to

late notice of a lawsuit because “unlike most notices of claim — which must be

submitted promptly after the accident, while an insurer’s investigation has the

greatest potential to curb fraud — notices of legal action become due at a

moment that cannot be fixed relative to any other key event, such as the injury,

the discovery of the tortfeasor’s insurance limits or the resolution of the

underlying tort claim” (see id. at 498).

Brandon did not abrogate the no-prejudice rule and should not be extended to

cases where the carrier received unreasonably late notice of a claim. The facts

here, where no notice of claim was filed and the first notice filed was a notice

of law suit, are distinguishable from Brandon where a timely notice of claim was

filed, followed by a late notice of law suit, and distinguishable from

Rekemeyer, where an insured gave timely notice of the accident, but late notice

of a SUM claim. Argo was notified of the lawsuit against it in February, 2000

but did not notify GNY until May, 2001. The burden of establishing that the

delay was not unreasonable falls on the insured (see U.S. Underwriters Ins. Co.

v A&D Maja Const. Inc., 160 F Supp2d 565, 569, [SDNY 2001]).

Argo admits that Maidenek filed the lawsuit against it in late 1999, and that

it received notice of the claim in early 2000. Argo further admits that its

notice to GNY was late but argues that GNY has not shown prejudice as a result

of this late notice. Argo notified GNY 14 months after it was first served with

the lawsuit, and six months after a default judgment was entered against it.

Argo asks this court to extend the Brandon “prejudice analysis to notice of suit

in commercial policies where the notice was admittedly late.”

The rationale of the no-prejudice rule is clearly applicable to a late notice of

lawsuit under a liability insurance policy. A liability insurer, which has a

duty to indemnify and often also to defend, requires timely notice of lawsuit in

order to be able to take an active, early role in the litigation process and in

any settlement discussions and to set adequate reserves. Late notice of lawsuit

in the liability insurance context is so likely to be prejudicial to these

concerns as to justify the application of the no prejudice rule. Argo=s delay

was unreasonable as a matter of law and thus, its failure to timely notify GNY

vitiates the contract. GNY was not required to show prejudice before declining

coverage for late notice of law suit.

Accordingly, the order of the Appellate Division should be affirmed, with costs.

* * * * * * * * * * * * * * * * *

 

Order affirmed, with costs. Opinion by Judge G.B. Smith. Judges Ciparick,

Rosenblatt, Graffeo, Read and R.S. Smith concur. Chief Judge Kaye took no part.

 

 

 

Decided April 5, 2005

 

[1]Previously, “GNY issued a commercial-package insurance policy to Henry

Moskowitz that included commercial-liability insurance coverage for some 35

buildings in New York City.”

[2]”A condition precedent is >an act or event, other than a lapse of time,

which, unless the condition is excused, must occur before a duty to perform a

promise in the agreement arises=” (Oppenheimer & Co. v Oppenheimer, Appel, Dixon

& Co., 86 NY2d 685, 690 [1995][citations omitted]).

[3]Section IV–Commercial General–Liability Conditions

2.Duties in The Event of Occurrence, Offense, Claim or Suit

a. You must see to it that we are notified as soon as practicable of an

“occurrence” or an offense which may result in a claim (emphasis added). To the

extent possible, notice should include:

(1) How, when and where the “occurrence” or offense took place:

(2) The names and addresses of any injured person and witnesses; and

(3) The nature and location of any injury or damage arising out of the

“occurrence” or offense.

 

b. If a claim is made or “suit” is brought against any insured, you must:

1. Immediately record the specifics of the claim of “suit” and the date

received; and

2. Notify us as soon as practicable.

 

c. You and any other involved insured must:

1. Immediately send us copies of any demands, notices, summonses or

legal papers received in connection with the claim or “suit”;

2. Authorize us to obtain records and other information;

3. Cooperate with us in the investigation or settlement of the claim or

defense against the “suit” and;

4. Assist us, upon our request, in the enforcement of any right against

any person or organization which may be liable to the insured because of injury

or damage to which this insurance may also apply.

 

d. No insured will, except at that insured’s own cost, voluntarily make

a payment, assume any obligation, or incur any expense, other than for first

aid, without our consent.

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